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Should I stay at home with my depression?

answered 12:30 PM EST, Sun December 04, 2011
I am really having a hard time with depression. I don’t really want to tell people at the office about my diagnosis. I am now on a daily 60 mg of Cymbalta but only a week or so in and not feeling any better yet. I just wish everyone at work would leave me alone. I just can’t bear to talk to anyone these days and It is hard enough for to get my job done without having to spend the energy needed to socialize and I just really can’t be bothered to care about anyone right now. I know that sounds terrible but it is true.

I am thinking about applying to work in a remote capacity. My work can be done online and I have the clout to pull the move. My wife, who is the only one who knows I am dealing with this, thinks that this is a bad idea. She is worried that I will become very isolated and this will make my depression worse. She does not know how hard it is for me to walk down that corridor every morning and exchange greetings with people…

Would reducing my contact with others have a negative effect on my mood? I feel like taking away anything that is making my life harder right not is the right thing to do, but I am not sure I am able to concentrate enough to really make solid rational decisions either.

Dr. Ari Hahn Says...

Dr. Ari Hahn A. Hahn

The quick and dirty answer is that you should not make any changes in your work or social life that has any modicum of permanence. If you were to stay away from the office for a limited period of time (say 2-4 weeks) and engage in a vigorous program to revitalize yourself, that might be a good plan. That type of plan needs strong coaching to keep you on track, and it can include many factors. I will try to explain further on.

Depression is a very difficult condition, and unfortunately extremely common. It is called "the common cold of mental health." There are many reasons for it being so common, the main one is that it is probably a name for many different clinical pictures.

But first, I must tell you that anti-depressant medications take at least two weeks before you feel the effects. Even if medication can completely solve your problem, it will take time. I strongly suggest that you keep it up for a few more weeks, if there are no problematic side effects. If there are, then you need to go back to your physician and try a different medicine.

Although medication is helpful, it rarely is a complete answer. The scientific community recognizes that depression is a catch all diagnosis for symptoms that come from many different causes. Most therapists do not work differentially according to different types of depression, and the medical/pharmaceutical  community is interested in calling it one disease in order to sell more pharmaceuticals. If your depression is caused only by accumulated stress (with no trauma, social or biological causes) then there is a reasonable chance that your serotonin (a brain chemical) is depleted and antidepressants might be the key (although there is evidence that in some cases adding serotonin can increase depression.) 

Even if the medication will solve the depression, it can only make you feel "undepressed." If you have been suffering for any length of time it is possible that you have gotten out of the habits and behaviors that enhance positive emotions. All doctors and most therapists follow the medical model of ridding a person from the "pathogen" or whatever is making the person feel bad, and expect the patient to be "all better." That works for medical issues, but not for emotional ones. Being "undepressed" does not make a person flourish. For that he or she needs to build personal strengths. There are a growing number of therapists that work with people to develop the parts of your personality that can make you feel good. This might be along the lines of creativity or better relationships, or helping behaviors, or many other things that fit one's particular personality. If this is accomplished then medication is less likely to be needed in the long run.

If you have enough control over your circumstances I would suggest the following. First give another week to see if the medication is having a positive effect. If yes, continue and stay on the job. If not, consider working at home for four weeks, with a commitment to go back to the office at the end of four weeks. 

Either way, contract with a therapist that can work with you on building your positive strengths. (I can help you, if you want.) Expect to work with that therapist for at least three months in order to have your innate flourishing skills blossom and take root. If you need to be working from home, expect to dedicate a serious amount of effort on a daily basis to the things that will make you feel good. If you go on at the office, then, while you still need to work on building positive, your focus will be less intense.

Without actually getting to know you I cannot be anymore specific. But I hope this is helpful. Again, if you want to talk about it, Choose Help has my profile, and I would love to talk to you.

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Page last updated Dec 04, 2011

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